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3 Strategies for Getting Things Done - Part 2

27 April 2017

Today’s blog continues from yesterday’s, which I recommend you read first.

In frustration at the inevitable failure of attempts to CONVINCE others of what needs to be done, the approach to effecting action can become something of an arms race; when winning the argument through rational means has foundered, looking to secure, consolidate and leverage power bases is what's left. 

This tips the approach to getting things done into COERCION, transforming the dynamic from one of securing buy in to one of securing compliance and, in so doing, eroding intrinsic commitment to the agenda.

While this approach often creates the appearance of alignment it is only ever tacit. Formal plans and governance mechanisms that describe and document a cascade of sub-objectives, each derived from a central shared focus, only paper over the cracks. Meanwhile, the underlying Forces of Friction are further deepened and entrenched by the use of power over - not power with - others.

There is though, a second and perhaps even more pernicious problem with relying on coercion as a means for getting things done.

In this - now surely famous? - video, Dan Pink illustrates that for all but the most mechanistic tasks, the use of extrinsic motivators makes performance worse.

When the impetus to do something proceeds from coercion (however subtle), rather than from a commitment to the intrinsic value of a task, things go bad. Predictably.

It’s easy to see how this argument applies to knowledge work, since such work is clearly not a simple mechanistic task.

One of my clients in healthcare, Tom Lewis, describes this over on his blog, bringing to life how it applies to his work as a consultant in a pathology service. Tom writes:

“Some things in life require choices between different options. These may be complex, but once made, the world generally moves on.

    • should I apply for this job?;
    • should I choose this school for my children?;
    • should I start a beta-blocker to reduce blood pressure in this patient?

But there are other things which do not lend themselves to this sort of decision making. There exists an ongoing tension between polarities.

    • should I spend more time doing clinical work / more time in a leadership role;
    • my children should be independent / we should do more as a family;
    • we should use antibiotics earlier in infections to stop serious consequences / we should hold back on antibiotics to prevent growth in resistance and other problems of over treatment.

These problems don't lend themselves to simple decisions. Rather they are ongoing tensions to be managed continuously.

So for example, for antibiotics we might have:

Benefits of early treatment

  • Get better quickly
  • Prevent complications
  • Early discharge
  • Clinician engagement with prescribing decisions

Benefits of delayed treatment

  • Reduce antibiotic usage
  • Protect 'good' bacteria
  • Reduce C difficile rates
  • More standardisation of infection management

Harms of early treatment

  • Overtreat
  • More C difficile
  • More resistance
  • More collateral damage
  • 'Random' approaches to antibiotic prescribing

Harms of delayed treatment

  • Undertreat
  • Delayed recovery
  • More complications
  • More serious infections
  • Less clinician engagement

Tom goes on to explain:

“What we see are people endlessly embroiled in attempting to solve problems at one end of the polarity or the other. How can I reduce antibiotic resistance? How can I improve the time to antibiotics in patients with suspected sepsis? And in doing so tending to lose sight of the opposite polarity.

This often leads to entrenchment in negative positions and disharmony between those with opposing world views.

Alternatively, we see short term shifts towards one pole, and then lurches back the other way. Tension becomes unproductive swings in approach.”

These problems go much wider than knowledge work.

In the context of organisations, it’s all but impossible to identify anything that can be safely reduced to a "simple mechanistic task".

Here’s an example from another client…

A grounds-keeping firm in the south of England had an annual summertime contract to cut the grass at a number of local parks, twice per month.

The firm had been doing this work for years and the turnover from it had become key to offsetting their overheads. However, as local authority budgets had come under pressure so too had the profitability of the contract.

Desperate to maintain turnover and feeling powerless to ask for more money or to raise the spectre of reduced service, the firm decided to cut corners. Henceforward, maintenance crews would cut the same grass at the same parks, twice on the same visit. This would prevent the need to return to each park later in the month.

With this singular move the firm could fulfil the contract at its current service level (twice per month), whilst saving time, fuel and cost.

Cutting grass seems like exactly the sort of activity that should qualify as a simple mechanistic task. But in the context of organisations, even such simple tasks are housed within complex environments; environments where multiple domains of performance need to be understood together, in the round, not individually and in isolation.

“Keeping the grass short” is one outcome but within a spectrum of outcomes, all of which matter, such as maintaining revenue, reducing costs, managing capital assets and so on.

In relying on coercion as the means for getting things done, the purpose of work is traduced and replaced by a narrow view, which distorts performance in the round and throws it off-balance.

This dynamic creates fire fighting too. Today’s priorities become a reaction to those domains of performance that were not being attended to with the same vigour yesterday and so the error is carried forward.

Refocusing which domains to prioritise in isolation is not a recognition that to manage performance in the round we need to manage the environment that is causing it not the individual performance symptoms that it is producing.

As with relying on rational strategies for getting things done (see PART 1), attempts to COERCE focus and effort leave our organisations stuck in a counter-productive loop, where sub-optimal performance is locked in - guaranteed by the very means that are being used to try and effect better performance.

Come back tomorrow for what happens when organisations adopt COPRODUCTION as their means to getting things done.


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